Rady Children’s Hospital agrees to continue gender-affirming care for minors under California court order

SAN DIEGO (CN) — Rady Children’s Hospital will continue providing gender-affirming care to adolescent patients as part of an agreement it reached with the state of California Wednesday.

Under the agreement, the hospital will continue to provide care for adolescent patients with an amendment that will include puberty blocker implants. The puberty blockers will be permitted if they are deemed necessary by a medical provider and under the condition that the state does not decide where the procedures take place, according to attorneys present during a hearing in San Diego Superior Court.

The temporary restraining order that prevents the children’s hospital from denying gender-affirming care will continue until the parties meet again early next year.

The California Attorney General’s Office initially filed a lawsuit against the children’s hospital early this year after it closed its gender-affirming care program for patients under 19 on Jan. 20 following a declaration from Health and Human Services Secretary Robert F. Kennedy Jr. that threatened to cut funding for medical providers who give the treatment to minors.

Gender-affirming care includes the psychological, medical and sometimes surgical treatment used to support a patient’s gender identity.

The state says the decision to end the care violated a legally binding condition between Attorney General Rob Bonta on Rady Children’s Hospital of San Diego’s merger with the Children’s Hospital of Orange County.

San Diego Superior Court Judge Matthew Braner granted a temporary restraining order in February that prevented the children’s hospital from preventing the care, with the exception of surgeries.

Braner also suggested pausing a separate but related case involving four Rady Children’s Hospital patients who filed a class action claiming civil rights violations in March until the matter between the California Attorney General’s Office was resolved. However, attorneys representing the patients in that case objected.

Helen Tran, an attorney for the Western Center on Law & Poverty, told the judge that her clients’ lawsuit relied on fundamentally different legal arguments than those in the attorney general’s case — although both cases stem from the same issue. Tran and her colleagues argued to keep their lawsuit concurrent with the attorney general’s lawsuit.

“The TRO addresses emergency relief we might seek in our case, but it does not address emergency relief that we are seeking in our case,” Lori Rifkin, an attorney with the Impact Fund, told Braner. “The cases are not identical, and we have not had a chance to brief that in court. We don’t think it makes sense to have an overriding decision that our case is fundamentally stayed until after their case.”

The plaintiffs in that case say Rady’s termination of its gender-affirming care programs singles out and discriminates against transgender people in California and will ultimately cause harm to the thousands of young people and their families, including approximately 1,900 other patients who receive the care from its pediatric health system.

The four main plaintiffs range between 12 and 18 years old, Rifkin said. Some of the patients moved to California specifically for the protections the state offered transgender people, she said.

“They worry every day whether they’re going to be able to continue to get the medications that they need as they’re going through adolescence, as they’re going through puberty,” Rifkin said during an impromptu press conference outside of the courtroom.
”So for them, the question, ‘What’s going to happen in six months? What’s going to happen in three weeks?’ is vitally important, and they need to be able to rely on the fact that Rady will give them care in accordance with the rights under California law.”

A federal judge in Oregon vacated Kennedy’s declaration that threatened to cut funding from medical providers for providing gender-affirming care in March after a coalition of 21 states sued Kennedy and the Health and Human Services Department.

Under the current temporary restraining order, patients are still able to receive the same level of care they received before Jan. 20, Rifkin said. But the ongoing court orders since then have been confusing and unfair to patients, she added.

“The really good part of all of this is that many patients in this area can still go to Rady, even though Rady continues to fight their obligation to provide that care,” she said.

Rady Children’s Hospital is the largest pediatric health system in California. Without it, patients would have to travel hundreds of miles for care, Rifkin said.

Attorneys representing Rady Children’s Hospital declined to comment on the case.

Attorneys are expected to discuss the merits of the state case during a hearing in January.